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Observational Study
. 2017 Aug:73:13-19.
doi: 10.1016/j.pediatrneurol.2017.05.009. Epub 2017 May 18.

Cumulative Incidence of Seizures and Epilepsy in Ten-Year-Old Children Born Before 28 Weeks' Gestation

Laurie M Douglass  1 , Timothy C Heeren  2 , Carl E Stafstrom  3 , William DeBassio  4 , Elizabeth N Allred  5 , Alan Leviton  5 , T Michael O'Shea  6 , Deborah Hirtz  7 , Julie Rollins  4 , Karl Kuban  4
Affiliations
Observational Study

Cumulative Incidence of Seizures and Epilepsy in Ten-Year-Old Children Born Before 28 Weeks' Gestation

Laurie M Douglass et al. Pediatr Neurol. 2017 Aug.

Abstract

Objective: We evaluated the incidence of seizures and epilepsy in the first decade of life among children born extremely premature (less than 28 weeks' gestation).

Method: In a prospective, multicenter, observational study, 889 of 966 eligible children born in 2002 to 2004 were evaluated at two and ten years for neurological morbidity. Complementing questionnaire data to determine a history of seizures, all caregivers were interviewed retrospectively for postneonatal seizures using a validated seizure screen followed by a structured clinical interview by a pediatric epileptologist. A second pediatric epileptologist established an independent diagnosis based on recorded responses of the interview. A third epileptologist determined the final diagnosis when evaluators disagreed (3%). Life table survival methods were used to estimate seizure incidence through ten years.

Results: By age ten years, 12.2% (95% confidence interval: 9.8, 14.5) of children had experienced one or more seizures, 7.6% (95% confidence interval: 5.7, 9.5) had epilepsy, 3.2% had seizure with fever, and 1.3% had a single, unprovoked seizure. The seizure incidence increased with decreasing gestational age. In more than 75% of children with seizures, onset was after one year of age. Seizure incidence was comparable in both sexes. Two-thirds of those with epilepsy had other neurological disorders. One third of children with epilepsy were not recorded on the medical history questionnaire.

Significance: The incidence of epilepsy through age ten years among children born extremely premature is approximately 7- to 14-fold higher than the 0.5% to 1% lifetime incidence reported in the general pediatric population. Seizures in this population are under-recognized, and possibly underdiagnosed, by parents and providers.

Keywords: epilepsy; extreme prematurity; low gestational age; newborn; rate; risk; seizure incidence.

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Conflict of interest statement

Conflict of Interest Statement: The authors have no conflicts of interest relevant to this article to disclose.

Figures

Figure 1
Figure 1
Cumulative incidence of seizures and epilepsy in children born extremely preterm.
Figure 2
Figure 2
Cumulative incidence of any seizure in children born extremely preterm, by gestational age category.
See this image and copyright information in PMC

References

    1. Aziz K, Vickar DB, Sauve RS, Etches PC, Pain KS, Robertson CM. Province-based study of neurologic disability of children weighing 500 through 1249 grams at birth in relation to neonatal cerebral ultrasound findings. Pediatrics. 1995;95(6):837–844. - PubMed
    1. De Groote I, Vanhaesebrouck P, Bruneel E, et al. Outcome at 3 years of age in a population-based cohort of extremely preterm infants. Obstet Gynecol. 2007;110(4):855–864. - PubMed
    1. Marret S, Marchand-Martin L, Picaud JC, et al. Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study. PloS One. 2013;8(5):e62683. - PMC - PubMed
    1. Moore T, Hennessy EM, Myles J, et al. Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies. BMJ. 2012;345(Journal Article):e7961. - PMC - PubMed
    1. Herrgard EA, Karvonen M, Luoma L, et al. Increased number of febrile seizures in children born very preterm: relation of neonatal, febrile and epileptic seizures and neurological dysfunction to seizure outcome at 16 years of age. Seizure. 2006;15(8):590–597. - PubMed

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